PARKINSONISM ASSOCIATED WITH OBSTRUCTIVE HYDROCEPHALUS DUE TO IDIOPATHIC AQUEDUCTAL STENOSIS

Two cases of parkinsonism after recurrent obstructive hydrocephalus du e to idiopathic aqueductal stenosis are reported. In both patients an extrapyramidal syndrome was noted in the absence of contemporaneous ev idence of hydrocephalus or shunt failure. One of the patients underwen t a shunt operation, but showed no clinical improvement. However, both patients improved after the administration of dopaminergic therapy. T he seven previously reported cases of this syndrome were reviewed and it is concluded that the prognosis of the parkinsonism is good, usuall y with total, or near total, resolution. It is recommended that if a p atient with idiopathic aqueduct stenosis develops hydrocephalus or evi dence of shunt malfunction in association with acute parkinsonism thei r shunt should be replaced. If there is no evidence of hydrocephalus o r shunt malfunction they should initially be treated with domaminergic medication.